Anja Hetland Smeland1, Tone Rustّen1, Alison Twycross1, Stefan Lundeberg1, Hanne Reinertsen1
Norway
One of the reasons why pediatric pain management is still underestimated and undertreated is nurses’ attitudes and lack of knowledge about pain management. The aim of this study was to explore nurses’ knowledge regarding pediatric postoperative pain management and their clinical practice, and to explore a possible link between knowledge and clinical practice.
The study was conducted in the post-anesthesia care (recovery) units of all six university hospitals in Norway. A cross-sectional design was used, where nurses (n=259) completed the "Pediatric Nurses’ Knowledge and Attitudes Survey Regarding Pain Questionnaire-Norwegian version” (PNKAS-N). In addition, data were collected about nurses' clinical practice using a structured observational tool (checklist) and field notes.
The PNKAS-N was completed by 193 nurses (response rate 75%), who also were observed giving postoperative care to 302 children (416 hours in total). The mean score on the PNKAS-N was 29 (72%) out of 40. The observational study revealed that 23% of the nurses used pain assessment tools on 17% of the children. In relation to pharmacological pain relief, 85% of the children were given paracetamol, 26% were given NSAIDs, and 41% of the children were given opioids postoperatively, where half of them received doses of less than 0.05mg/kg.
Knowledge deficits were identified in pharmacological management, risks of addiction and respiratory depression. In addition, a valid pain assessment tool was not always used. Children are receiving suboptimal pain management and there is a need to improve practice in this area. There seems to be a link between nurses’ knowledge and their clinical practice in most fields.
Participants, hospital staff
Renee Manworren, Mary T. Rieman, permission to use PNKAS, Kari Hovde permission to use Norwegian version of PNKAS
Medicines for Children Network, Norway, Children's Surgical Department, OUS, Norway, Norwegian Nurses Organization, Sykehusbarn, Support from South-Eastern Norway Regional Health Authority
